儿童免疫性血小板减少症合并流感病毒感染临床研究
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摘要
目的研究儿童免疫性血小板减少症(ITP)和流感病毒感染之间的关系。方法选择确诊ITP患儿44例为ITP组,同期住院确诊贫血儿童20例为对照组,包括缺铁性贫血11例,失血性贫血9例。ELISA法检测血标本流感病毒抗体。根据流感病毒抗体检测结果进一步将ITP组分为流感病毒组和非流感病毒组,比较两组治疗前血小板(PLT)计数,治疗后血小板分布宽度(PDW)、平均血小板体积(MPV)、血小板压积(PCT)、大血小板比例(P-LCR)。结果 ITP组流感病毒感染率明显高于对照组,差异有统计学意义(P<0.05),流感病毒组和非流感病毒组初发时血小板计数比较差异无统计学意义,治疗后流感病毒组PDW、MPV、P-LCR均高于非流感病毒组,差异均有统计学意义(P<0.05),流感病毒组PCT低于非流感病毒组,差异有统计学意义(P<0.05)。结论流感病毒感染参与儿童免疫性血小板减少症的发病且提示预后。
Objective To explore the relationship between immune thrombocytopenia and influenza virus infection in children. Methods 44 children diagnosed with ITP were served as ITP group, in the same period, 20 cases of anemia were treated as control group, including 11 cases of hypoferric anemia, 9 cases of hemorrhagic anemia. Detection of influenza virus antibody in blood samples by ELISA method. According to the detection results of influenza virus antibody, the ITP group was further divided into influenza virus group and non influenza virus group, compared the PLT count between two groups before treatment, platelet distribution width after treatment(PDW), mean platelet volume(MPV), plateletcrit(PCT),platelet large cell ratio(P-LCR) were compared after treatment. Results The Influenza virus infection rate in ITP group was significantly higher than the control group, the difference was statistically significant(P<0.05), influenza virus group and non influenza virus group primary platelet count had no significant difference, after treatment, the PDW, MPV, P-LCR in influenza virus group were higher than non influenza virus group, when PCT was lower, the difference was statistically significant(P<0.05). Conclusion Influenza virus infection is involved in the pathogenesis of childhood immune thrombocytopenia and suggests prognosis.
Objective To explore the relationship between immune thrombocytopenia and influenza virus infection in children. Methods 44 children diagnosed with ITP were served as ITP group, in the same period, 20 cases of anemia were treated as control group, including 11 cases of hypoferric anemia, 9 cases of hemorrhagic anemia. Detection of influenza virus antibody in blood samples by ELISA method. According to the detection results of influenza virus antibody, the ITP group was further divided into influenza virus group and non influenza virus group, compared the PLT count between two groups before treatment, platelet distribution width after treatment(PDW), mean platelet volume(MPV), plateletcrit(PCT),platelet large cell ratio(P-LCR) were compared after treatment. Results The Influenza virus infection rate in ITP group was significantly higher than the control group, the difference was statistically significant(P<0.05), influenza virus group and non influenza virus group primary platelet count had no significant difference, after treatment, the PDW, MPV, P-LCR in influenza virus group were higher than non influenza virus group, when PCT was lower, the difference was statistically significant(P<0.05). Conclusion Influenza virus infection is involved in the pathogenesis of childhood immune thrombocytopenia and suggests prognosis.
引文
[1]江载芳,申昆玲,沈颖.诸福棠实用儿科学[M].8版.北京:人民卫生出版社,2015:1896-1899.
[2] Ekstrand C, Linder M, Cherif H, et al. Increased susceptibility to infections before the diagnosis of immune thrombocytopenia[J]. Journal of Thrombosis&Haemostasis Jth, 2016,14(4):807.
[3] Smalisz-Skrzypczyk K, Romiszewski M, Matysiak M, et al. The Influence of Primary Cytomegalovirus or Epstein-Barr Virus Infection on the Course of Idiopathic Thrombocytopenic Purpura[J]. Advances in Clinical Science, 2015(878):83.
[4] Huang CE, Chen YY, Chang JJ, et al. Thrombopoietic cytokines in patients with hepatitis C virus-associated immune thrombocytopenia[J]. Hematology, 2017,22(1):54-60.
[5] Shindo T, Nishijima T, Teruya K, et al. Combination of high-dose dexamethasone and antiretroviral therapy rapidly improved and induced long-term remission of HIV-related thrombocytopenic purpura[J]. Journal of Infection&Chemotherapy Official Journal of the Japan Society of Chemotherapy, 2013,19(6):1170-1172.
[6]李凡,徐志凯.医学微生物学[M].8版.北京:人民卫生出版社,2013:238-240.
[7] Bitzan M, Zieg J. Influenza-associated thrombotic microangiopathies[J]. Pediatric Nephrology, 2017(26):1-17.
[8]陈俐丽,文飞球.免疫性血小板减少性紫癜的诊断和治疗进展[J].中华实用儿科临床杂志,2010,25(15):1201-1204.
[9]李虎,胡鹏.甲型H7N9流感病毒血凝素和神经氨酸酶的进化及抗原位点变异分析[J].中华医学杂志,2013,93(30):2381-2384.
[10]李月,代震宇,张德纯.血小板分布宽度作为新型血小板活化特异性标志物的评价[J].重庆医科大学学报,2011,36(2):200-202.
[11]白静,刘文君.儿童原发性免疫性血小板减少症血小板参数及功能变化[J].临床儿科杂志,2015,33(9):797-801.
[2] Ekstrand C, Linder M, Cherif H, et al. Increased susceptibility to infections before the diagnosis of immune thrombocytopenia[J]. Journal of Thrombosis&Haemostasis Jth, 2016,14(4):807.
[3] Smalisz-Skrzypczyk K, Romiszewski M, Matysiak M, et al. The Influence of Primary Cytomegalovirus or Epstein-Barr Virus Infection on the Course of Idiopathic Thrombocytopenic Purpura[J]. Advances in Clinical Science, 2015(878):83.
[4] Huang CE, Chen YY, Chang JJ, et al. Thrombopoietic cytokines in patients with hepatitis C virus-associated immune thrombocytopenia[J]. Hematology, 2017,22(1):54-60.
[5] Shindo T, Nishijima T, Teruya K, et al. Combination of high-dose dexamethasone and antiretroviral therapy rapidly improved and induced long-term remission of HIV-related thrombocytopenic purpura[J]. Journal of Infection&Chemotherapy Official Journal of the Japan Society of Chemotherapy, 2013,19(6):1170-1172.
[6]李凡,徐志凯.医学微生物学[M].8版.北京:人民卫生出版社,2013:238-240.
[7] Bitzan M, Zieg J. Influenza-associated thrombotic microangiopathies[J]. Pediatric Nephrology, 2017(26):1-17.
[8]陈俐丽,文飞球.免疫性血小板减少性紫癜的诊断和治疗进展[J].中华实用儿科临床杂志,2010,25(15):1201-1204.
[9]李虎,胡鹏.甲型H7N9流感病毒血凝素和神经氨酸酶的进化及抗原位点变异分析[J].中华医学杂志,2013,93(30):2381-2384.
[10]李月,代震宇,张德纯.血小板分布宽度作为新型血小板活化特异性标志物的评价[J].重庆医科大学学报,2011,36(2):200-202.
[11]白静,刘文君.儿童原发性免疫性血小板减少症血小板参数及功能变化[J].临床儿科杂志,2015,33(9):797-801.